The "General Welfare" Clause

I was in a discussion tonight of the Constitutionality of Medicare, Medicaid, and the Health Care Reform package recently passed into law. It was my contention that the enumerated powers of the legislative branch did not include setting national health care policy or levying taxes to pay for health care subsidies while my friend contended that the phrase:

The Congress shall have Power To lay and collect Taxes, Duties, Imposts andExcises, to pay the Debts and provide for the common Defence and generalWelfare of the United States; but all Duties, Imposts and Excises shall beuniform throughout the United States;

From Article I, Section 8 meant that congress could make a determination that some act was for the "general welfare" of the United States and implement a law outside of the enumerated powers immediately following in the rest of the section. (US Constitution)

Aside from the punctuation, Federalist #41 addresses this argument for unconstrained government with the following observation:

Had no other enumeration or definition of the powers of the Congress been found in the Constitution, than the general expressions just cited, the authors of the objection might have had some color for it; though it would have been difficult to find a reason for so awkward a form of describing an authority to legislate in all possible cases.

It is interesting to me that the arguments are the same, but the sides have changed.

When citizens of the confederated independent states of America argued against ratifying the Constitution, they argued that the wording of certain passages would free government from any constraints. Now, certain citizens of the United States argue that these exact same passages free government from any constraints.

Nevertheless, the Federalist Papers offer a guide to understanding the Constitution. Many provisions in the Constitution seem archaic, and some are reminders of a past that will never leave us, but the Federalist Papers bring much of the Constitution home in a way a stand alone reading can't. They were written primarily by James Madison and Alexander Hamilton, who both attended the Constitutional Convention and so write with authority on the mindset and intention of the drafters with each provision.

While the punctuation and language of the US Constitution may leave some aspects open for interpretation, the entire document must be considered and the interpretation must be consistent with the rest of the Constitution. It is not subject to being discarded or interpreted into meaninglessness especially in contravention to the expressed intention and meaning those responsible for writing it.